| NPI | 1982705331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MA 205736) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A79123) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-09-28 |