| NPI | 1992719504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: UT 360179-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 3601791205) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-12-20 |