| NPI | 1417455205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35.055520) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.055520) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |