| NPI | 1699704445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD173366) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A93713) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2015-12-02 |