| NPI | 1558432336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology Body Imaging (Licence: DC MD4034) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: DC MD4034) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: DC MD4034) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-09-19 |