| NPI | 1386857357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 47906) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 4301084044) |
| 207R00000X Internal Medicine (Licence: MI 4301084044) | |
| 207U00000X Nuclear Medicine (Licence: CT 47906) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-01-28 |