| NPI | 1194959502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OR 10884) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2009-05-13 |