| NPI | 1316198088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 4780) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 4780) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2016-01-19 |