| NPI | 1992099113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KS 04-39666) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 32061) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39666) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2023-11-30 |