NPI | 1447396809 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: CA A84308) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A84308) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2022-12-29 |