| NPI | 1386697993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: PA MD021778E) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: PA MD021778E) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2012-05-22 |