| NPI | 1457470213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: PR 9549) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 9549) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PR 9549) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2010-08-20 |