| NPI | 1386977205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IA MD-04044) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA 20A10430) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: IA MD-04044) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WI 61738-21) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2019-04-04 |