| NPI | 1861437428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME0070951) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME0070951) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2015-01-06 |