| NPI | 1831287374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 28377) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C51705) |
| 207U00000X Nuclear Medicine (Licence: CA C51705) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-06-28 |