| NPI | 1881661783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 53380) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102201435) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-00808) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 46720) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 105018) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2011-06-13 |