| NPI | 1396481727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 74781) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND PT23142) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-11-24 |