| NPI | 1336240845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR DO184015) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA OP60766680) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA OP60766680) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB08156000) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2021-11-30 |