| NPI | 1780611350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 417230) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19057) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2002027108) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-08-04 |