| NPI | 1952514796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A103153) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD434928) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2015-06-23 |