| NPI | 1013909605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 13900) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OK 13900) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OK 13900) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2011-12-22 |