| NPI | 1700115789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WI 63564) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WI 63564) |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2023-07-26 |