NPI | 1811344823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 62540) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 390200000) |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MN 62540) | |
Enumeration Date | 2016-05-19 |
Last Update Date | 2021-06-24 |