| NPI | 1942206990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 16434) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G75889) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2024-10-31 |