| NPI | 1023012622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NC 2004-00268) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2012-09-11 |