| NPI | 1871607176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: VA 0101029773) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MD D45557) |
| 207U00000X Nuclear Medicine (Licence: NC 7008) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101029773) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D45557) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 7008) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |