NPI | 1467528638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: ND 10442) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 10442) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2020-11-11 |