NPI | 1871868174 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C186770) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 53864) |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CT 53864) | |
2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA C186770) | |
Enumeration Date | 2012-03-20 |
Last Update Date | 2024-04-19 |