| NPI | 1669743712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CO DR.0053063) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0053063) |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2023-12-15 |