NPI | 1710956883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: OK 2741) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 2741) |
Enumeration Date | 2006-03-14 |
Last Update Date | 2013-06-12 |