| NPI | 1861447245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M6643) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: ID M6643) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: WA MD00032355) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2014-02-13 |