NPI | 1497773097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ND 6205) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 34645) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2011-11-30 |