| NPI | 1598850042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35054025) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35054025D) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-06-26 |