| NPI | 1073696159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35036045) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2012-01-13 |