| NPI | 1669458741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OK 26733) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0005699) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2009-01-06 |