| NPI | 1700864261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WA MD00035253) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: HI 24396) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: WA MD00035253) | |
| 2085N0904X (Licence: PA MD455386) | |
| 208D00000X General Practice (Licence: WA Md00035253) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2024-11-21 |