| NPI | 1760509293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 027429) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CT 027429) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2013-08-14 |