| NPI | 1326153701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 022848) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025692) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 2954) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-08-20 |