| NPI | 1619300241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME156084) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME156084) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2024-08-15 |