| NPI | 1093940298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 68166) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A82593) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX M9699) | |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2023-04-05 |