NPI | 1134452501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301095424) |
Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 4301095424) |
Enumeration Date | 2009-09-16 |
Last Update Date | 2021-03-04 |