| NPI | 1700236452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 62499) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 62499) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-07-09 |