| NPI | 1578750758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A100990) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A100990) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: CA A100990) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2024-04-09 |