| NPI | 1740268879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MN 25077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 25077) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2019-05-06 |