| NPI | 1447247044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PR 10991) | 
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: PR 10991) | 
| Enumeration Date | 2005-09-29 | 
| Last Update Date | 2010-08-23 |