| NPI | 1437101292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AK 6584) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IA 36611) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MN 49387) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-03-27 |