| NPI | 1326254012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 5267) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: SC 5267) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: SC 5267) | |
| 2083T0002X Preventive Medicine, Medical Toxicology (Licence: SC 5267) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-09-11 |