| NPI | 1376639781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: DC MD14014) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MD D0014662) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |