| NPI | 1194740308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 034428) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 246164) |
| 207U00000X Nuclear Medicine (Licence: CT 034428) | |
| 207U00000X Nuclear Medicine (Licence: MA 246164) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2018-01-16 |