| NPI | 1487754370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 78039) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 213622) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-12-18 |