| NPI | 1194783530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NV 7042) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G73117) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G73117) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA G73117) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2026-01-30 |