| NPI | 1699976449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: HI MD1882) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD1882) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2025-09-11 |