| NPI | 1265411664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 44907) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MA 44907) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2012-04-05 |