| NPI | 1578518817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301037517) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301037517) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2014-07-10 |