NPI | 1982647475 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 33692) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO 33692) |
Enumeration Date | 2006-06-13 |
Last Update Date | 2012-01-25 |