| NPI | 1467665596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0031197) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD14142) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: DC MD14142) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MD D0031197) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2013-06-28 |