| NPI | 1396789780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ID M3046) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-3046) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2008-12-31 |