| NPI | 1679537328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G80355) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2017-02-17 |