| NPI | 1992792899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23857) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA A84037) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2020-12-21 |