| NPI | 1770575193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME43778) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME43778) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2023-11-07 |