| NPI | 1821401159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA RHL00202905) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16367) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 64907) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2025-02-06 |