| NPI | 1609862853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 042924) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: CT 042924) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: CT 042924) | |
| 207U00000X Nuclear Medicine (Licence: CT 042924) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2007-07-13 |