| NPI | 1841313178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0062210) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A97755) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-06-10 |