| NPI | 1598744971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: OR 14616) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OR 14616) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2007-07-08 |