| NPI | 1235186024 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MI 4301084802) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME 60466) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MA 50347) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 176142-1) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2014-01-30 |