| NPI | 1912108622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: FL ME94550) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME94550) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2018-03-15 |