| NPI | 1962492231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: MA 49988) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MA 49988) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 49988) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2012-08-09 |