| NPI | 1679598197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0430642) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 4273-320) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2025-07-31 |