| NPI | 1023335775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2011-01331) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NC 2011-01331) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2018-03-23 |