| NPI | 1578500401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111563) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: IA 36670) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 36670) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2022-12-20 |