| NPI | 1144377896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 14230612-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A95684) |
| 207U00000X Nuclear Medicine (Licence: DC MD039600) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-08-28 |