| NPI | 1740201540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 41482) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-34639) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104345) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-04-09 |