NPI | 1144474826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301093279) |
Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: KY R1737) |
2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301093279) | |
Enumeration Date | 2008-11-08 |
Last Update Date | 2014-08-10 |