| NPI | 1689601098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: IA 35674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 35674) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-07-16 |