| NPI | 1760482475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NV 13742) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: AL 22741) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2016-05-23 |