| NPI | 1922172436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301050028) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 050028) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 050028) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2015-02-25 |