NPI | 1902026982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI L1068791) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI L1068791) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2013-01-10 |