NPI | 1124023759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: CA A49923) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A49923) |
Enumeration Date | 2005-06-20 |
Last Update Date | 2007-07-09 |