| NPI | 1235582610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 70360) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PA MD457520) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: PA MD467520) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD467520) | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2022-07-13 |