| NPI | 1063616464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD61314277) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ME MD19973) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KY 44830) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NH 20613) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2025-04-14 |