| NPI | 1063577005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DE C1-0010195) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WI 1899) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10010195) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-12-13 |