| NPI | 1841221108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 5101011123) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101011123) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-10-08 |