| NPI | 1811950827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA RHL133112) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA RHL133112) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-03-07 |