| NPI | 1053304550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 76291) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: FL ME 76291) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: FL ME 76291) | |
| 2085N0700X Radiology Neuroradiology (Licence: FL ME 76291) | |
| 207U00000X Nuclear Medicine (Licence: FL ME 76291) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: FL ME 76291) | |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: FL ME 76291) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2007-07-13 |