| NPI | 1477768083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0010059) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-00130) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-06-30 |