| NPI | 1134229859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 40048) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WI 40878) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 40878) | |
| 2085B0100X Radiology, Body Imaging (Licence: IA 40048) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: IA 40048) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2015-02-18 |