| NPI | 1457567034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX D5004) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX D5004) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-08-05 |