| NPI | 1417920448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35055654) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35055654) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-08-04 |