| NPI | 1821011487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MD D0060486) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: VA 0101236162) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD30367) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |