| NPI | 1982917332 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: PA MD481428)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD481428)  | 
| Enumeration Date | 2010-07-14 | 
| Last Update Date | 2023-07-24 |