| NPI | 1922380914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL os13300) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL os13300) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2025-08-04 |