| NPI | 1164569083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 49938) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MD V0918) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2017-02-08 |