| NPI | 1063486835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO 31953) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NM A-1345-05) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2009-07-01 |