| NPI | 1710129093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A114242) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A114242) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A114242) | |
| 208D00000X General Practice (Licence: CA A114242) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2023-06-11 |