| NPI | 1063573384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 011991) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA 3643) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-04-05 |