| NPI | 1720007404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: KS 0430825) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: KS 0430825) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-30825) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: KS 0430825) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: KS 04-30825) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-11-20 |