| NPI | 1558443465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: AZ 11239) |
| Additional Taxonomies | 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology (Licence: AZ 11239) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-09 |