| NPI | 1356474175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H1349) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TX H1349) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: TX H1349) | |
| 207UN0903X Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine (Licence: TX H1349) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2024-03-26 |