| NPI | 1427626019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 82182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL17507) |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2026-06-10 |