| NPI | 1760778369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NE 959) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 959) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2020-06-01 |