| NPI | 1083058168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX T5916) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX T5916) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OK 35728) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2024-01-24 |