NPI | 1831776699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: HI dos-2325-0) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 7812) |
Enumeration Date | 2021-03-26 |
Last Update Date | 2022-08-30 |