| NPI | 1265480495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 14841) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: SC 14841) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-06-07 |