| NPI | 1366446890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: CA C191570) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L0663) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2026-06-09 |