| NPI | 1225245921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 51933) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: MD P26885) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-10-04 |