| NPI | 1235349127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME77252) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |