NPI | 1588750764 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX L3147) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L3147) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2011-01-20 |