| NPI | 1720512411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: TX U0457) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U0457) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2023-07-11 |