| NPI | 1912369448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TX R5644) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R5644) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A172681) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2024-05-01 |