| NPI | 1982742805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 2300) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PR 2300) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2014-11-18 |