| NPI | 1225176324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OR MD09593) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD09593) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-11-15 |