| NPI | 1427322320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35.066738) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 186116) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA G61540) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TX G1672) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AZ 11418) | |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |