| NPI | 1235291659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MD D17690) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D17690) |
| 207Q00000X Family Medicine (Licence: MD D17690) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2012-01-11 |