| NPI | 1952542995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 13726) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26772) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 94-08336) | |
| Enumeration Date | 2009-03-22 |
| Last Update Date | 2015-07-21 |