| NPI | 1548242951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 38211) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 33034) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2020-10-20 |