| NPI | 1093841777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X (Licence: DC MD600006195) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MD D0108168) |
| 2085N0904X (Licence: OH 35-085202) | |
| 2085N0904X (Licence: TX T7260) | |
| 207U00000X Nuclear Medicine (Licence: TX T7260) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2026-09-28 |