| NPI | 1487793493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-33474) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM 2004-0256) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2008032496) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-02-13 |