| NPI | 1184843716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 34465) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TN 34465) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TN 34465) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |