| NPI | 1720183874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NM 2000-308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 2000-308) |
| 208D00000X General Practice (Licence: NM 2000-308) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-10-15 |