| NPI | 1740786847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MN 65871) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 65871) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 29292) | |
| 208600000X Surgery (Licence: MN 29292) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2023-06-30 |