| NPI | 1245296805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 05-32945) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2008007219) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2023-06-08 |