| NPI | 1669439386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: NC 26210) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 26120) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NC 26120) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2011-11-29 |