| NPI | 1144208661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: UT 328507-1204) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 378) |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: NE 378) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-12-19 |