| NPI | 1437253176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 23886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 23886) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2015-08-03 |