| NPI | 1992730311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 1236) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: ME 1236) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-06-27 |