| NPI | 1013956572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS11952) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 029974) |
| 207Q00000X Family Medicine (Licence: GA 29974) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL OS11952) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-10-25 |