| NPI | 1275569535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-30249) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 22513) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2016-08-08 |