| NPI | 1467432245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 20313) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 20313) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ 20313) | |
| 207P00000X Emergency Medicine (Licence: AZ 20313) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2012-09-18 |