| NPI | 1295868230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: MI 4301052098) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OH 35055101) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2009-08-18 |