NPI | 1043740525 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: KY 04934) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101023132) |
Enumeration Date | 2017-06-15 |
Last Update Date | 2024-06-12 |