| NPI | 1841398955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301082666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301082666) |
| 208600000X Surgery (Licence: MI 4301082666) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-07-18 |