| NPI | 1588693980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-16665) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19053) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2002029460) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2015-08-04 |