| NPI | 1770750432 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 54424) | 
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WI 54424) | 
| Enumeration Date | 2008-05-13 | 
| Last Update Date | 2020-12-31 |