NPI | 1750374245 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: IL 036046268) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 036046268) |
Enumeration Date | 2005-08-30 |
Last Update Date | 2023-05-10 |