| NPI | 1104912385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TX D6830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX D6830) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2021-06-14 |