| NPI | 1790748549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WA MD00024699) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WA MD00024699) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2014-07-22 |