NPI | 1013470244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171000000X Military Health Care Provider |
Additional Taxonomies | 208D00000X General Practice (Licence: AL A194844) |
Enumeration Date | 2019-04-14 |
Last Update Date | 2024-11-20 |