| NPI | 1376550418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083T0002X Preventive Medicine, Medical Toxicology (Licence: TX G7554) | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX G7554) | 
| Enumeration Date | 2006-08-02 | 
| Last Update Date | 2025-09-11 |