| NPI | 1396706677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NH 9656) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: NC 29931) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MA 150196) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2017-01-19 |