| NPI | 1083026041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A199880) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NM MD2022-0401) |
| 2085N0904X (Licence: CA A199880) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2025-07-17 |