| NPI | 1316943251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SD 2540) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: SD 2540) |
| 207Q00000X Family Medicine (Licence: SD 2540) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-03-02 |