| NPI | 1538579099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: UT 9560102-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74408) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2023-10-07 |