| NPI | 1356332373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: CA g89012) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA56685) |
| 207U00000X Nuclear Medicine (Licence: WA MD00046429) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NJ 25MA56685) | |
| 208D00000X General Practice (Licence: NJ 25MA56685) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2021-11-29 |