| NPI | 1952846784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 69568) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 69568) |
| 208D00000X General Practice (Licence: MN 69568) | |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2022-07-22 |