| NPI | 1720332406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME30444) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: FL ME30444) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |