| NPI | 1467494187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-5605) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ID M-5605) |
| 208D00000X General Practice (Licence: ID M-5605) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-03-16 |