| NPI | 1396744827 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OR MD190137) | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL ME0112109) | 
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VA 0101238448) | |
| Enumeration Date | 2005-07-18 | 
| Last Update Date | 2021-03-25 |