| NPI | 1174834576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: FL ME137212) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: MO 2013009624) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2020-09-01 |