| NPI | 1134266695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: GA 038370) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA G60378) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME 79048) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX K9670) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |