| NPI | 1649682089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2019012966) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MO 2019012966) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 41120) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2024-02-21 |