| NPI | 1033440631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2019007127) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-473646) |
| 286500000X Military Hospital | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2023-03-15 |