| NPI | 1245328624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 24112) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: KY 17296) |
| 208D00000X General Practice (Licence: KY 17296) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2013-05-03 |