| NPI | 1154353282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OK 4258) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4258) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-12-28 |