| NPI | 1821012089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AR c5423) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AR c5423) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-12-03 |