| NPI | 1306919063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: KY 31893) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OH 35-054031) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2022-01-13 |