| NPI | 1144842378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-53107) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 85340) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2026-06-30 |