| NPI | 1831163005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2005030243) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0431648) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2017-02-21 |