| NPI | 1720617962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 94-10694) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: KS 94-10694) |
| 2085N0700X Radiology, Neuroradiology (Licence: MO 2021023178) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2021023178) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2025-02-18 |