| NPI | 1104979970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: PA MD043437E) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |