| NPI | 1710270806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: UT 9129303-1205) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: UT 9129303-1205) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2024-03-07 |