| NPI | 1639113269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A23741) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A23741) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-01-09 |