| NPI | 1467460345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: MD D31447) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MO 2003003231) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: KY 42032) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 42032) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-08-16 |