Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 1899 | WI |
NPI | 1063577005 |
---|---|
Provider Name | Demetrios J Agriantonis |
First Address | Newark, DE 19718 |
Second Address | Newark, DE 19718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/11/2016 |