| NPI | 1750320305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 09827) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 09827) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: SC 09827) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-05-06 |