| NPI | 1891796249 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 183478-1205) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD26862) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-8460) | |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: OR MD26862) | |
| Enumeration Date | 2005-08-09 | 
| Last Update Date | 2025-09-01 |