| NPI | 1891789020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL 106965) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME106965) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2020-10-29 |