| NPI | 1679549166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 3604) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: FL OS8335) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA OP61629350) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2024-12-18 |