| NPI | 1316351323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 269046) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: GA 84345) |
| 207U00000X Nuclear Medicine (Licence: AR E-17658) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: GA 84345) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: MA 269046) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-17658) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 334168) | |
| 207U00000X Nuclear Medicine (Licence: MA 269046) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2025-01-15 |