| NPI | 1992293559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ND 19627) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 66846) |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2024-06-18 |