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 |