| NPI | 1780772327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MO 107231) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KS 05-67213) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2008-09-29 |