| NPI | 1689832941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA C178867) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 244847) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2023-08-09 |