| NPI | 1437460284 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34.011442)  | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 34.011442)  | 
| Enumeration Date | 2010-06-27 | 
| Last Update Date | 2015-02-03 |