| NPI | 1447458427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: TN 46273) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116019075) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2013-09-17 |