| NPI | 1215095948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OH 35.056920) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MI 4301057261) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2009-07-09 |