| NPI | 1487804068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO DR.0056211) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101244018) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2020-12-28 |