| NPI | 1023455854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 77978) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A131884) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 85094) | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2025-03-17 |