| NPI | 1245250356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 10848) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 48924) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-11-13 |