| NPI | 1669565651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NY 149922-1) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: GA 052031) |
| 207U00000X Nuclear Medicine (Licence: SC 23210) | |
| 207U00000X Nuclear Medicine (Licence: NC 200201540) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: NY 149922-1) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: SC 23210) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: GA 052031) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: NC 200201540) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052031) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 23210) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200201540) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 149922-1) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |