| NPI | 1336152230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 43575) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 043575) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: GA 043575) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: GA 43575) | |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: GA 43575) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2024-11-25 |