| NPI | 1891895017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: LA 14176R) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MS 17479) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |