| NPI | 1205986890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 23560) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 31243) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2012-02-02 |