| NPI | 1568450419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: IA 26627) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 26627) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2007-12-11 |