| NPI | 1366401630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 17158) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WV 17158) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WV 17158) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-04-15 |