NPI | 1275576480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: PA OS004112L) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS004112L) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2015-09-15 |