| NPI | 1578623971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301043724) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301043724) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |