| NPI | 1336387919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX G6439) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G6439) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2020-04-23 |