NPI | 1124050596 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX L8734) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L8734) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2025-09-11 |