NPI | 1063478956 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MI 4301078897) |
Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 4301078897) |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 120621) | |
207QA0505X Family Medicine, Adult Medicine (Licence: MI 4301078897) | |
207QA0505X Family Medicine, Adult Medicine (Licence: OH 120621) | |
2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OH 120621) | |
Enumeration Date | 2006-04-21 |
Last Update Date | 2013-12-04 |