| NPI | 1407069248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL OS6196)  | 
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NE 160)  | 
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NM 84-248)  | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NM A-794-84)  | |
| Enumeration Date | 2007-05-08 | 
| Last Update Date | 2022-07-21 |