| NPI | 1952306268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2002-01344) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NC 2002-01344) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 200201344) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-09-12 |