| NPI | 1578725990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A110416) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MDR-5511) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2022-10-28 |