| NPI | 1679906580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A179353) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA MD60751368) |
| 2085B0100X Radiology, Body Imaging (Licence: WA MD60751368) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60751368) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2023-11-21 |