| NPI | 1396865440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0101019896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101019896) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2016-01-04 |