| NPI | 1275545865 |
|---|---|
| Other Name | NONE NONE NONE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OK 21113) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: TX L6283) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2023-07-07 |