| NPI | 1649891086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA 004815) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: PR 00000) |
| 208D00000X General Practice (Licence: FL HSE30385) | |
| 208D00000X General Practice (Licence: NJ 017990) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-05-19 |