NPI | 1194165688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: FL os14976) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL os14976) |
Enumeration Date | 2013-06-27 |
Last Update Date | 2025-05-27 |