| NPI | 1366522823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: TX J8619) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J8619) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-08-20 |