| NPI | 1891227252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 73635) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 22561) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-01053) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 77477) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-05-20 |