| NPI | 1033118633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TN 39598) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: TN 39598) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2007-07-08 |