| NPI | 1528569902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V5255) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: ME DO2965) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: TX V5255) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME DO2965) | |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2025-02-24 |