| NPI | 1568451649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 64496) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A86185) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: AZ 64496) | |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: CA A86185) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2021-10-29 |