| NPI | 1831247204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: MA 59705) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 59705) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: PA MD034356E) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD034356E) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2024-05-01 |