| NPI | 1962750497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TX R5339) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: CA A130001) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2018-03-05 |