| NPI | 1104446491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MO 2025033553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2025033553) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2025-08-13 |