| NPI | 1023171964 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OK 10020) | 
| Enumeration Date | 2006-12-19 | 
| Last Update Date | 2007-07-08 |