| NPI | 1114154960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: KS 0440613) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2025-04-10 |