| NPI | 1306866694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 29144) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MN 29144) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 29144) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-12-17 |