| NPI | 1245389071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 20349) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AL 20349) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: AL 20349) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AL 20349) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-08 |