| NPI | 1962685800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: OK 28591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 28591) |
| 207R00000X Internal Medicine (Licence: PR 19145) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: PR 19145) | |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2016-02-04 |