| NPI | 1104890797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0071049) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: MD D0071049) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2012-01-03 |