| NPI | 1124336029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NC 2016-01298) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2016-09-01 |