| NPI | 1043521024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0437347) |
| Additional Taxonomies | 173000000X Legal Medicine |
| 207R00000X Internal Medicine (Licence: KS 9407484) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2020-10-20 |