| NPI | 1891086476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 76728) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA WT198847) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2024-10-03 |