NPI | 1497018782 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CA A156847) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA 156847) |
Enumeration Date | 2012-06-21 |
Last Update Date | 2021-09-21 |