| NPI | 1376917781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301104848) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: MO 2015018271) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301104848) | |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2024-03-06 |