| NPI | 1336166008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2004009614) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0438996) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 32656) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-06-21 |