| NPI | 1245200252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-28772) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2000161124) |
| 174400000X Specialist (Licence: MO 2000161124) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2026-07-14 |