| NPI | 1326061177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 155674) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 43630-020) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-04-08 |