| NPI | 1437144706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 51784) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MA 51784) |
| 207U00000X Nuclear Medicine (Licence: MA 51784) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2026-03-17 |