| NPI | 1073716882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PR 6799) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301064899) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2007-07-08 |