| NPI | 1235573098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME164712) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME164712) |
| 2085N0904X Radiology Nuclear Radiology (Licence: WA MD60942728) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD60942728) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2023-12-21 |