| NPI | 1568572519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 42635) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA TR00045282) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX FTL 42195) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2009-07-15 |