| NPI | 1588693832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-20010) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 276643) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2016-08-08 |