| NPI | 1336266014 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NE 12480)  | 
| Enumeration Date | 2007-03-26 | 
| Last Update Date | 2012-04-06 |