| NPI | 1477112191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: KY 60179) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TN Na) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-12-18 |