| NPI | 1154376143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 78860) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MA 78860) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-07-31 |