| NPI | 1316053747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00039043) |
| Additional Taxonomies | 207UN0903X Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine (Licence: WA MD00039043) |
| 202C00000X Independent Medical Examiner (Licence: WA MD00039043) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-04-28 |