| NPI | 1992826184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q6990) |
| Additional Taxonomies | 2085N0904X (Licence: MA 235135) |
| 2085N0700X (Licence: MA 235135) | |
| 207U00000X Nuclear Medicine (Licence: MA 235135) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D73493) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2016-03-15 |