| NPI | 1881666022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 43264) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 61270) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2025-03-04 |