| NPI | 1891807863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: WA MD00045187) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00045187) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-10-28 |