| NPI | 1144725755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX s2734) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX S2734) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-06-26 |