| NPI | 1376691428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: KY 19630) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KY 19630) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |