NPI | 1235295072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WV 18830) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 18830) |
Enumeration Date | 2006-12-28 |
Last Update Date | 2024-09-23 |