| NPI | 1972603439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 71589) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 047010) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D65323) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-09-01 |