| NPI | 1154454098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 27866) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: SC 27866) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2019-05-06 |