| NPI | 1902260706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 286534) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: MA 286534) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2021-10-10 |