NPI | 1134408487 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1334) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS M061101) |
Enumeration Date | 2011-08-04 |
Last Update Date | 2021-07-19 |