| NPI | 1053307124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: VA 0101057818) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: CT 042247) |
| 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NJ 25MA07041600) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CT 042247) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: VA 0101057818) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2023-11-30 |