| NPI | 1003815424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D35404) |
| Additional Taxonomies | 207PT0002X Emergency Medicine Medical Toxicology (Licence: MD D35404) |
| 207RI0200X Internal Medicine Infectious Disease (Licence: MD D35404) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MD D35404) | |
| 2083T0002X Preventive Medicine Medical Toxicology (Licence: MD D35404) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: MD D35404) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2010-02-17 |