| NPI | 1871657692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: FL OS17777) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02003129A) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-04-22 |