| NPI | 1265706097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10047982) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TX P8886) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2024-04-18 |