| NPI | 1508835596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 38130) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WI 38130) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-01-07 |