| NPI | 1750590030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 062589) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A102326) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2012-10-29 |