| NPI | 1275577850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 113275) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 05-39181) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2022-07-21 |