| NPI | 1962848838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 11748789-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-08059) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2021-10-19 |