| NPI | 1336129287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PA OS002000L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS002000L) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PA OS002000L) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2007-07-08 |