| NPI | 1649245218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00003463) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME72144) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 38202) | |
| 207U00000X Nuclear Medicine (Licence: AL 00003463) | |
| 207U00000X Nuclear Medicine (Licence: FL ME72144) | |
| 207U00000X Nuclear Medicine (Licence: TN 38202) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2011-12-19 |