| NPI | 1114258191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0009846) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: ND 17308) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2023-12-28 |