| NPI | 1417213125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA MD008527E) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: DE C1-0002461) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |