| NPI | 1891029625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: PA MT193028) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MD443722) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2011-08-10 |