| NPI | 1851650030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 62433) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: WI 62433) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2022-10-25 |