| NPI | 1255317376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MN 28137) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2011-12-14 |