| NPI | 1871750638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: AZ 010080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56074-21) |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: WI 56074-21) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2023-06-19 |