| NPI | 1245229574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME87506) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 87506) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2023-01-27 |