| NPI | 1760590012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101058418) |
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: VA 0101058418) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: VA 0101058418) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2024-05-09 |