| NPI | 1265937049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: CA A165127) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A165127) |
| 207U00000X Nuclear Medicine (Licence: CA A165127) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-05-14 |