| 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 |