| NPI | 1174963227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA MD034163E) |
| Additional Taxonomies | 208U00000X Clinical Pharmacology (Licence: PA MD034163E) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2015-12-29 |