| NPI | 1841366770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 51546-020) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A97631) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2003007553) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2019-08-29 |