| NPI | 1104909605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: DC MD12216) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MD D24815) |
| 207U00000X Nuclear Medicine (Licence: LA MD06798R) | |
| 207U00000X Nuclear Medicine (Licence: VA 0101047688) | |
| 207U00000X Nuclear Medicine (Licence: PA MD064853L) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D24815) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD12216) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101047688) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD064853L) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD06798R) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-09 |