| NPI | 1982603486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G38212) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA G38212) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2008-08-15 |