| NPI | 1205864766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME133440) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 4301071798) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-07-21 |