NPI | 1124314000 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0067852) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101253518) |
Enumeration Date | 2011-06-20 |
Last Update Date | 2023-08-02 |