| NPI | 1851506604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2018-00911) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 253692) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-09-22 |