| NPI | 1275873515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: KS 05-45378) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NE 1221) |
| Enumeration Date | 2013-02-24 |
| Last Update Date | 2022-03-15 |