| NPI | 1215433578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: TN 66742) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 24254) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-05-03 |