| NPI | 1356875819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME150737) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME150737) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-08-08 |