| NPI | 1669479168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: SD 3770) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SD 3770) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2013-12-03 |