| NPI | 1396999512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60993530) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: OR MD195622) |
| 207U00000X Nuclear Medicine (Licence: WA MD60993530) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 57914) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: WA MD60993530) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 13406) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R3227) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD195622) | |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2020-10-07 |