| NPI | 1497872303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX L7836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK AA2388) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2014-10-30 |