NPI | 1598949166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 030915) |
Additional Taxonomies | 208D00000X General Practice (Licence: GA 030915) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2021-03-30 |