| NPI | 1639174865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: KS 04-30741) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: MO 2005016216) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2014-08-04 |