| NPI | 1023197126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 200200929) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NC 200200929) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-09-02 |