| NPI | 1558369900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-01961) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PA MD059410L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD059410L) | |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2023-03-07 |