| NPI | 1427284033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 52276) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 53334) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2018-12-07 |