| NPI | 1447750419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X (Licence: FL ME134152) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: FL ME134152) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME134152) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2021-04-01 |