| NPI | 1477604296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: LA 329100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 30413) |
| 207Q00000X Family Medicine (Licence: TX L7153) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX L7153) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MS 30413) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2023-09-01 |