| NPI | 1821134297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 8248) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PR 8248) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2024-07-16 |