| NPI | 1366413346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: KS 04-27514) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-27514) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: KS 04-27514) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-04-17 |