| NPI | 1700801537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 43301) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE CI0007946) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 056577) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-12-23 |