| NPI | 1548217508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G45215) |
| Additional Taxonomies | 2085N0904X (Licence: CA G45215) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-11-24 |