| NPI | 1366605602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: GA 66166) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 291302-1) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2018-11-07 |