| NPI | 1588826283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101273096) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101273096) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-07-26 |