| NPI | 1104825918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: SD 5236) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MN 47112) |
| 207U00000X Nuclear Medicine (Licence: IA 35827) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2009-10-26 |