| NPI | 1649447525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TX P1213) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 238724) |
| Enumeration Date | 2008-05-10 |
| Last Update Date | 2012-02-27 |