| NPI | 1265524292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MI 4301049953) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: MI 4301049953) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301049953) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 11687156-1205) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2023-11-15 |