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 |