| NPI | 1255506341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX P7395) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 001013) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2014-11-19 |