NPI | 1982088571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MO 2018011353) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2018011353) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2018-06-11 |