| NPI | 1588631477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME79952) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME79952) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2019-09-05 |