| NPI | 1407893621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G32352) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA g32352) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2016-09-29 |