NPI | 1801129044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: PR 17704) |
Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: PR 17704) |
Enumeration Date | 2009-09-04 |
Last Update Date | 2017-02-07 |