| NPI | 1588637326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 28552) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AZ 28552) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2014-09-05 |