| NPI | 1316040603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 75492) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MA 75492) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2012-02-23 |