| NPI | 1699705467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 363A00000X) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: VT 0320000527) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2017-01-11 |