| NPI | 1528070521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 102445) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 48938) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME98406) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-26 |