| NPI | 1952444010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 51672) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: KS 6422) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2011-05-19 |