| NPI | 1952499048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 50419) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.205834) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0007600) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-04-13 |