NPI | 1760472013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 13694) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL 13694) |
Enumeration Date | 2005-10-27 |
Last Update Date | 2007-07-08 |