| NPI | 1407013253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR DO196822) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: CT 044952) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CT 044952) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2020-02-13 |