| NPI | 1215958665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: FL me77077) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL me77977) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL me77977) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-09-11 |