| NPI | 1346279973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19366) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 30978) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 31638) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-03-07 |