| NPI | 1750578241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A100868) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX S2746) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2024-09-10 |