| NPI | 1689836231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 56865) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 106918) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2013-09-12 |