| NPI | 1669534962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 51287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 51287) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IN 02004051A) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2021-04-14 |