| NPI | 1477534311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: OK 14267) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D32076) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-07-20 |