| NPI | 1194818328 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: DC MD210002730) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 048182) | 
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2022-10-24 |