| NPI | 1932227907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 101770) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: MO 101770) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: MO DO101770) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-02-17 |