| NPI | 1598860439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MA 34385) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 34385) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |