| NPI | 1891953816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 36240) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0436306) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2019-02-28 |