| NPI | 1285999557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 63233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6839) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 6908) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 29887) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 71217) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2020-09-28 |