| NPI | 1477510543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NM A-1224-03) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NM A122403) |
| 208600000X Surgery (Licence: NM A122403) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2017-01-30 |