NPI | 1346315124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TX R4995) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101240249) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2021-04-27 |