| NPI | 1760572127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-18173) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G152671) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2025-03-20 |