| NPI | 1992242028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 204160) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R9235) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2024-05-16 |