| NPI | 1699731836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J2634) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 14699) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-19229) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2007-07-08 |