| NPI | 1346687696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 22270) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: LA M.D.013167) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MS 08134) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX G9652) | |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |