| NPI | 1922186840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MA 37053) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 37053) |
| 207R00000X Internal Medicine (Licence: CT 34370) | |
| 207R00000X Internal Medicine (Licence: RI MD10701) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 37053) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CT 34370) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: RI MD10701) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CT 34370) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-01-04 |