| NPI | 1427232040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KS 04-20432) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: KS 04-20432) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2012-07-09 |