| NPI | 1982859211 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: LA 13125)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 13125)  | 
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: LA 13125)  | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: LA 13125)  | |
| 2083T0002X Preventive Medicine, Medical Toxicology (Licence: LA 13125)  | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: LA 13125)  | |
| Enumeration Date | 2008-12-01 | 
| Last Update Date | 2008-12-01 |