| NPI | 1831171552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: CT 042865) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 042865) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2007-07-08 |