| NPI | 1033209903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WI 55074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00020882) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-04-18 |