NPI | 1821415944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: CA A163300) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A163300) |
Enumeration Date | 2014-03-26 |
Last Update Date | 2024-08-22 |