NPI | 1548675036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: OK 5769) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-06-24 |
Last Update Date | 2023-11-24 |