| NPI | 1205816329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MN 28842) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: MN 28842) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-08-21 |