| NPI | 1477837383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO DR.0058341) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101019615) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2019-07-09 |