| NPI | 1922268606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P8996) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A133846) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2020-06-03 |