| NPI | 1881956589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-38946) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WI 67159-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 67159) | |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2018-07-13 |