| NPI | 1336137264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301064214) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 4301064214) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2012-01-10 |