| NPI | 1972729226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-35206) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME125941) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2012001748) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 39663) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-05-17 |