| NPI | 1992710131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA G35876) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: CA RHL128733) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2024-07-02 |