| NPI | 1760598460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO R2G72) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MO R2G72) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2019-08-28 |