NPI | 1205160454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ Arizona) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ 4936) |
Enumeration Date | 2009-09-21 |
Last Update Date | 2009-09-21 |