NPI | 1093800716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: KS 05-29348) |
Additional Taxonomies | 208D00000X General Practice (Licence: KS 05-) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2019-01-16 |