| NPI | 1134351992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: MD D0014646) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0014646) |
| 207R00000X Internal Medicine (Licence: ME MD18454) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2020-08-28 |