| NPI | 1437285129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 70492) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 000227) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CT 000227) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-03-23 |