| NPI | 1548402753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G27154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD 14868) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G27154) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: HI MD 14868) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2009-04-02 |