| NPI | 1417996992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: MI 5101007569) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |