| NPI | 1508836750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: IA 33093) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 33093) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2022-08-31 |