| NPI | 1043715477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 65890) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 81860) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-07-05 |