| NPI | 1093830333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 17949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G66859) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: AZ 17949) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA G66859) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |