| NPI | 1164774295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: DC MD31020) |
| Additional Taxonomies | 2083T0002X Preventive Medicine, Medical Toxicology (Licence: DC MD31020) |
| Enumeration Date | 2012-10-13 |
| Last Update Date | 2012-10-13 |