| NPI | 1730107202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MO 32218) |
| Additional Taxonomies | 2085N0904X (Licence: MO 32218) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 32218) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-04-17 |