| NPI | 1265403893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD056884L) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PA MD056884L) |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD056884L) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2021-06-16 |