| NPI | 1134278641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 72792) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: LA MD.203197) |
| 207U00000X Nuclear Medicine (Licence: PA MT185345) | |
| 2085N0904X (Licence: LA MD.203197) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2025-01-27 |