| NPI | 1922064005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 34284) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NC 34284) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NC 34284) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2010-06-01 |