| NPI | 1104814094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: IA 28587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 28587) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2007-11-28 |