| NPI | 1760512016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 037520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA GA037520) |
| 207U00000X Nuclear Medicine (Licence: GA GA037520) | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: GA GA037520) | |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: GA GA037520) | |
| 207UN0903X Nuclear Medicine In Vivo & In Vitro Nuclear Medicine (Licence: GA GA037520) | |
| 261QR0200X Clinic/Center Radiology (Licence: GA 037520) | |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: GA 037520) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: GA 037520) | |
| 207QA0505X Family Medicine Adult Medicine (Licence: GA 037520) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: GA 037520) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: GA 037520) | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: GA 037520) | |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: GA 037520) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-10-19 |