NPI | 1184910101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: DE C10010996) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 558502) |
Enumeration Date | 2011-06-28 |
Last Update Date | 2014-10-28 |