| NPI | 1992735542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-18392) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19059) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2002021166) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-04-08 |