| NPI | 1477816551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: GA 080396) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 266810) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2018-10-16 |