| NPI | 1043245731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NH EL11684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J8493) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX J8493) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-04-07 |