| NPI | 1801862727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MA 156173) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: MA 156173) |
| 2085B0100X Radiology Body Imaging (Licence: MA 156173) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2021-05-26 |