| NPI | 1447210281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: VA 0102050009) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: VA 0102050009) |
| 2083S0010X Preventive Medicine Sports Medicine (Licence: VA 0102050009) | |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: VA 0102050009) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2009-02-05 |