| NPI | 1659656668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: CA A38963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 02390150) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2016-09-14 |