| NPI | 1588004535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 70998) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A156100) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2022-03-29 |