| NPI | 1952313975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 48954) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 102417) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2024-05-29 |