| NPI | 1306939285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301407335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301407335) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 4301407335) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301407335) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |