| NPI | 1871687061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MI 5101006363) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MI 5101006363) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-10-17 |