| NPI | 1083729222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-27554) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 4257-320) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2025-07-31 |