| NPI | 1811194418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME114193) | 
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME114193) | 
| Enumeration Date | 2007-06-28 | 
| Last Update Date | 2024-10-11 |