| NPI | 1255468468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2013013690) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: IN 01025419) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2013-06-24 |