| NPI | 1073604633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: HI MD7240) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: HI MD-7240) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2019-08-09 |