| NPI | 1235118415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 27366) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 27366) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2024-03-15 |