| NPI | 1952835050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 64092) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: ND 19624) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2024-01-16 |