| NPI | 1730548181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 30181) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NE 30181) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61321849) | |
| Enumeration Date | 2016-02-14 |
| Last Update Date | 2024-08-30 |