| NPI | 1487976668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A113116) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 4301086547) |
| 207U00000X Nuclear Medicine (Licence: CA A113116) | |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2012-02-28 |