| NPI | 1467866178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0438267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9408359) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R6862) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-10-20 |