| NPI | 1982646758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: WA MD00010959) |
| Additional Taxonomies | 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: WA MD00010959) |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: WA MD00010959) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2007-07-08 |