| NPI | 1669422416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD27906) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A89001) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-05-13 |