| NPI | 1619088879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: MO R5D43) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO R5D43) |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: KS 04-29635) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: KS 04-26935) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-01-14 |