| NPI | 1659501443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: UT 13534934-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 6068) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2023-08-10 |