| NPI | 1679510259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MO 109864) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MO MD109864) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2022-09-14 |