| NPI | 1851660955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OR MD188949) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD188949) |
| 207Q00000X Family Medicine (Licence: IN 01047189A) | |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2021-06-21 |