| NPI | 1861421331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: MN 69802) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: WI 38312) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 38312) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-07-14 |