| NPI | 1205842101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 5101011102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101011102) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-11-21 |