| NPI | 1235291907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 041578) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: GA 041578) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2023-07-31 |