| NPI | 1700892254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 11400) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: MA 210652) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 210652) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-05-13 |