| NPI | 1255524146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NV 1236) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: NV 021214) |
| 208D00000X General Practice (Licence: ID 097) | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |