NPI | 1467568311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: PR 3860) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 3860) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2014-05-29 |