| NPI | 1508949538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MS 08920) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 08920) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MS 08920) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2010-11-02 |