| NPI | 1366512642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 01161340) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 01161340) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-10-25 |