| NPI | 1215918297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 180827-1205) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: UT 180827-1205) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2019-02-26 |