| NPI | 1982762365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: CA A32321) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: CA A32321) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A32321) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: CA A32321) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |