| NPI | 1952347270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 05-34770) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR DO218063) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 14217269-1234) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-09-15 |