| NPI | 1306093851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0436345) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 34486) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2014-04-02 |