| NPI | 1699948976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: FL ME 105894) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TX R2929) |
| 207U00000X Nuclear Medicine (Licence: IN 01076460A) | |
| 207U00000X Nuclear Medicine (Licence: NY 283034) | |
| 207U00000X Nuclear Medicine (Licence: GA 061499) | |
| 208D00000X General Practice (Licence: IN 01076460A) | |
| 208D00000X General Practice (Licence: NY 283034) | |
| 208D00000X General Practice (Licence: TX R2929) | |
| 208D00000X General Practice (Licence: FL me105894) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2022-08-11 |