| NPI | 1689936171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 55651) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME136595) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 106292) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 55644) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 69421) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2020-08-14 |