| NPI | 1467559328 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TN MD41940) | 
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AR R-3760) | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2012-06-19 |