NPI | 1487949103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: HI 16846) |
Additional Taxonomies | 208D00000X General Practice (Licence: NC 2019-02491) |
Enumeration Date | 2011-06-09 |
Last Update Date | 2023-08-18 |