| NPI | 1316263593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: GA 074823) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WY 9090A) |
| 208600000X Surgery (Licence: WY 9090A) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-05-04 |