| NPI | 1417905563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PR 13721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 13721) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-02-24 |