| NPI | 1851341796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME92831) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME92831) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2009-07-01 |