| NPI | 1285045849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-84293) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME125363) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 65115) | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2020-09-22 |