| NPI | 1033220298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60105377) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA MD60105377) |
| 207U00000X Nuclear Medicine (Licence: ID M-12248) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD208252) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-12248) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-04-18 |