| NPI | 1144340498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO 46066) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX K3941) |
| 207Q00000X Family Medicine (Licence: TX K3941) | |
| 207Q00000X Family Medicine (Licence: CO 46066) | |
| 207Q00000X Family Medicine (Licence: OR 46066) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2011-11-22 |