| NPI | 1942289376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101283016) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A92430) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2024-07-01 |