| NPI | 1033177662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS3562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS3562) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2009-08-05 |