| NPI | 1700022712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 282283) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A147571) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2020-12-17 |