| NPI | 1407842198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 10943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 10943) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2017-12-01 |