| NPI | 1639107964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: CA A24718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA 47991) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2022-07-27 |