| NPI | 1629047725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 26078) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: CO 26078) |
| 207R00000X Internal Medicine (Licence: WA OP 60017371) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2009-11-09 |