| NPI | 1548526825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 02206) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A133328) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2025-08-08 |