| NPI | 1962199786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: AZ 80187) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AZ 80187) |
| 2085B0100X Radiology, Body Imaging (Licence: AZ 80187) | |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2026-07-02 |