| NPI | 1730454208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME108428) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: LA 307847) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: LA 307847) | |
| 207U00000X Nuclear Medicine (Licence: NY 263610) | |
| 207U00000X Nuclear Medicine (Licence: FL ME 108428) | |
| Enumeration Date | 2012-03-17 |
| Last Update Date | 2018-09-28 |