| NPI | 1952422909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 99-322) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NM L3172) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2019-06-11 |