NPI | 1336189067 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CA G74901) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA G74901) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2018-10-09 |