| NPI | 1801996988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX N1757) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-8243) |
| 208D00000X General Practice (Licence: GA 020238) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: HI MD 8243) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2014-05-12 |