| NPI | 1427244037 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0001X (Licence: FL ME104231) | 
| Additional Taxonomies | 2085H0002X Radiology, Hospice and Palliative Medicine (Licence: FL ME104231) | 
| 2085R0001X (Licence: CA A93245) | |
| Enumeration Date | 2007-09-18 | 
| Last Update Date | 2025-05-06 |