| NPI | 1376736710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 5913) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PR 5913) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |