| NPI | 1770682114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TN MD12497) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: TN 12497) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD12497) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-09-29 |