| NPI | 1598119810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX s7158) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 291592) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-08-02 |