NPI | 1316061674 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: CA A72830) |
Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: CA A72830) |
Enumeration Date | 2007-03-19 |
Last Update Date | 2021-02-25 |