| NPI | 1518278514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: CO 0056621) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407485) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 0056621) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2018-04-27 |