| NPI | 1124373006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME134185) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA 141656) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2021-12-01 |