| NPI | 1568557213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: CO DR.0059313) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2003-00017) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0059313) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-07-21 |