| NPI | 1245245687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 38416) |
| Additional Taxonomies | 209800000X Legal Medicine (Licence: CO 38416) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CO 38416) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2017-08-24 |