| NPI | 1114093408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 17963-20) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 17963) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2013-04-22 |