| NPI | 1376694901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 31933) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2009010250) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 4013-320) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2025-07-31 |