| NPI | 1801096029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: PA MD440106) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: PA MT189404) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2015-09-01 |