| NPI | 1245247071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NV DO1538) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: MI 5101015443) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2024-11-18 |