| NPI | 1316991144 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 34710)  | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA 34710)  | 
| Enumeration Date | 2006-05-19 | 
| Last Update Date | 2009-06-29 |