| NPI | 1952478927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 50669) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 50669-20) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-09-23 |