| NPI | 1891796249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 183478-1205) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: OR MD26862) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD26862) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: ID M-8460) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-08-30 |