| NPI | 1154467322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX F1915) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX F1915) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-07-12 |