| NPI | 1982661823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: FL ME131273) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AR E-16511) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16511) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9600886) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 234701) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2024-04-23 |