| NPI | 1336130426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 49868) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME83092) |
| Enumeration Date | 2005-10-29 |
| Last Update Date | 2020-08-20 |