| NPI | 1699876367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AL 00010653) |
| Additional Taxonomies | 207UN0903X Nuclear Medicine In Vivo & In Vitro Nuclear Medicine (Licence: AL 00010653) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-17 |