| NPI | 1851822092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A184987) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-07-10 |