| NPI | 1487094157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: OR MD203606) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD203606) |
| 207U00000X Nuclear Medicine (Licence: AL L4482SP) | |
| 2085N0700X (Licence: AZ R 74143) | |
| 2085N0904X (Licence: AZ R74143) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.4482SP) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-06-02 |