| NPI | 1285751776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 52349) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 104553) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A94298) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-19 |