| NPI | 1679752026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS0005914) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL OS0005914) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |