NPI | 1205872256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: OH 34.006190) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.006190) |
Enumeration Date | 2006-06-20 |
Last Update Date | 2021-12-28 |