| NPI | 1720285109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PR 16811) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 16811) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2013-06-07 |