| NPI | 1609338003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 86038) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A181218) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WI 86038) | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-09-04 |