| NPI | 1609854173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 103509) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101238749) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 47265) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2016-06-17 |