| NPI | 1376523092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301071978) |
| Additional Taxonomies | 2085N0904X (Licence: MI 4301071978) |
| 207U00000X Nuclear Medicine (Licence: MI 4301071978) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2026-07-21 |