| NPI | 1275585887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101010989) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: MI 5101010989) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 5101010989) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 5101010989) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-07-31 |