NPI | 1720059066 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 10869) |
Additional Taxonomies | 174400000X Specialist |
207Q00000X Family Medicine (Licence: SC 10869) | |
Enumeration Date | 2006-01-26 |
Last Update Date | 2015-03-13 |