| NPI | 1871756155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 63891) |
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: GA 63891) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: GA 63891) | |
| 208D00000X General Practice (Licence: FL ME104760) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2022-11-09 |