| NPI | 1326201617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0435363) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407034) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 27149) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2016-08-08 |