| NPI | 1144202888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 33610) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: AZ 33610) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AZ 33610) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2020-10-02 |