| NPI | 1467147652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23181) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: PR 23181) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PR 23181) | |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2024-04-10 |