| NPI | 1669544151 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16249) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL OS16249) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2024-12-11 |