| NPI | 1124089503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD H0069823) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 2479) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0528428) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2023-03-09 |