| NPI | 1376592832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 23901) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 104663) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 27019) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.098953) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-01-23 |