| NPI | 1851658132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: SC 87234) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WA MD61054616) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-03-08 |