| NPI | 1760476360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 72091) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MA 72091) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2007-07-08 |