| NPI | 1033266838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME98463) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 36988) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-08-05 |