| NPI | 1306939285 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301407335)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301407335)  | 
| 207Q00000X Family Medicine (Licence: MI 4301407335)  | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 4301407335)  | |
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2025-09-11 |