| NPI | 1316101835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 51204) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 103826) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 50157) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2013-07-17 |