| NPI | 1982753356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0058423) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 4098) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 05-32677) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-12-08 |