| NPI | 1972902732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R8865) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TX R8865) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2024-12-16 |