| NPI | 1922102060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TX P5433) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX P5433) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-02-13 |