NPI | 1700027844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: DC MD18079) |
Additional Taxonomies | 208D00000X General Practice (Licence: MD D0025173) |
Enumeration Date | 2009-03-19 |
Last Update Date | 2009-03-19 |