| NPI | 1255349585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX G4346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX G4346) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2014-09-09 |