| NPI | 1952643595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD469383) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175815) |
| 208D00000X General Practice (Licence: NE 28139) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 28139) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2023-09-01 |