NPI | 1275568735 |
---|---|
Former Name | MARK C PHILLIPS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: OR MD18731) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: OR MD18731) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2023-03-07 |