| NPI | 1043288939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: PA MD019460E) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: PA MD019460E) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: PA MD019460E) | |
| 208D00000X General Practice (Licence: PA MD019460E) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2007-11-30 |