| NPI | 1205974052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 5101007429) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2014-03-12 |