| NPI | 1659352904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology Nuclear Radiology (Licence: MA 58918) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MA 58918) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2013-01-03 |