| NPI | 1710251582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: WI 19756-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 19756-20) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |