| NPI | 1285839027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX M3208) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A100626) |
| 207Q00000X Family Medicine (Licence: TX M3208) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2021-12-15 |