| NPI | 1992060198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A149745) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A149745) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2024-04-09 |