| NPI | 1265511869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0102201893) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2025-06-06 |