| NPI | 1609517812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA DO.OP.61517032) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ P24-00841) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-08-24 |