| NPI | 1215390737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MO 2006020958) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |