| NPI | 1447697321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 05-41563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6943) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018030152) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2025-03-06 |