| NPI | 1861486144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 14671) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 14671) |
| 173000000X Legal Medicine (Licence: PR 14671) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2016-08-10 |