NPI | 1386762490 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: HI 3200) |
Additional Taxonomies | 208D00000X General Practice (Licence: IN 01057638A) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2007-07-08 |