| NPI | 1972562767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 23174) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH4657) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AL 23174) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME83214) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL 23174) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2023-11-10 |