| NPI | 1275853012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA MD450041) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IN 01081684A) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WV 25594) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 2251) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2019-09-25 |