| NPI | 1609038272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: GA 93832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL31029) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2022-11-22 |