| NPI | 1124067269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME51842) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME0051842) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME51842) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-09-13 |