| NPI | 1942566971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0068186) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A126222) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2022-03-03 |