| NPI | 1053403030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: KS 04-25938) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-25938) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KS 04-25938) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2026-01-23 |