| NPI | 1336211101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ 56015) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35051440) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2018-09-11 |