| NPI | 1770533606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NE 17836) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 17836) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-08-13 |