| NPI | 1033286372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MD C0001738) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0001738) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2024-04-18 |