| NPI | 1326266867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 56046) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 40107) |
| 207U00000X Nuclear Medicine (Licence: WI 56046) | |
| 207U00000X Nuclear Medicine (Licence: IA 40107) | |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2017-01-09 |