| NPI | 1881135804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 6368) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 77075) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2023-08-07 |