| NPI | 1083852404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD30764) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: DC MD30764) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2020-11-28 |