| NPI | 1114151263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 61083) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 65815) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2023-10-02 |