| NPI | 1841357357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MO 2016003784) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02003984A) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IN 02003984A) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2019-03-13 |