| NPI | 1881836559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CT 039306) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: CT 039306) |
| 208D00000X General Practice (Licence: CT 039306) | |
| 207QS0010X Family Medicine Sports Medicine (Licence: CT 039306) | |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: CT 039306) | |
| 202C00000X Independent Medical Examiner (Licence: CT 039306) | |
| 2083B0002X Preventive Medicine Obesity Medicine (Licence: CT 039309) | |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2017-03-10 |