| NPI | 1396779286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: WI 25832-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 25832-020) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2021-12-29 |