| NPI | 1215550512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0101283178) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-09-10 |