| NPI | 1801876255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX H-5040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX H-5040) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-06-09 |