| NPI | 1093774523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME113751) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MO R6J47) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-09-26 |