| NPI | 1538196241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-14723) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19094) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2010-07-08 |