| NPI | 1548451073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 16796) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 50304) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2008-05-21 |