| NPI | 1720270184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A96285) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A96285) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: CA A96285) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2022-02-11 |