| NPI | 1033101571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME76808) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME76808) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME76808) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME76808) | |
| 207U00000X Nuclear Medicine (Licence: FL ME76808) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-01-20 |