NPI | 1457382467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MN 48607) |
Additional Taxonomies | 208600000X Surgery (Licence: MN 48607) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2007-07-16 |