| NPI | 1295266567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: UT 10964127-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: UT 10964127-1205) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-06-18 |