| NPI | 1407118318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017010079) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MO 2017010079) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2018-08-17 |