| NPI | 1346449147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TX N4348) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MD T2536) |
| 207U00000X Nuclear Medicine (Licence: NY 245240-1) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2012-02-01 |