| NPI | 1750341780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0002800) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD034535E) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2017-11-13 |