| NPI | 1992237754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 64308) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 21882) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2023-07-24 |