NPI | 1669562930 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A43491) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A43491) |
Enumeration Date | 2006-10-14 |
Last Update Date | 2007-07-08 |