| NPI | 1922083799 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 25986) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 25986) | 
| Enumeration Date | 2005-12-14 | 
| Last Update Date | 2021-05-20 |