| NPI | 1962083436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MO 2022014689) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4351047362) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2022-06-27 |