| NPI | 1528642519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA SPI667) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA SPI667) |
| 207U00000X Nuclear Medicine (Licence: CA SPI667) | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2022-07-14 |