| NPI | 1841847068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL HSE30383) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 389-P.A.) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2020-11-04 |