| NPI | 1265590749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: SD 1995) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 6414) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23475) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |