| NPI | 1194730689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CO 28419) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CO 28419) |
| 209800000X Legal Medicine (Licence: CO 281419) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |