| NPI | 1356550792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MD D50961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0050961) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-07-16 |