| NPI | 1669504494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 53939) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA a86448) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2021-11-18 |