| NPI | 1952837627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WI 100488) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PR 22727) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-06-27 |