| NPI | 1659261063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA FH1251569) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL HSE41427) |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2025-10-15 |