| NPI | 1972726222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C184440) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 231795) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2024-07-10 |